Organization
CHERRY STREET SERVICES INC
Active
Other names
Barry Communtiy Health Center - Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SHEA (CEO)
(616) 776-2129
Entity
Organization
Contact information
Practice address
1230 W STATE ST, HASTINGS, MI 49058-9712
(269) 945-4220
(269) 945-4229
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H80CS00770
HRSA
MI
Enumeration date
12/11/2014
Last updated
12/15/2014
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